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Skin Eruptions Signal Underlying Disorders

Skin is a window to the soul.

DERMATOLOGY Common cutaneous disorders may be benign or be an outward manifestation of an internal or systemic disease. A patient noticed the sudden onset of painful, erythematous lesions on her forehead. It appeared to be an insect bite, vasculitis, atypical pyderma gangrenosum, Behcet's disease or possible a herpes virus infection. But this turned out to be more than a dermatological concern. The patient had acute febrile neutrophilic dermatosis, first described by Sweet in 1964. [1] Sweet's syndrome may also be a reaction to a more serious condition, such as leukemia, or to certain medications. [2] A person cannot easily see within the body without the aid of special equipment. So when something is going wrong inside, the skin may provide clues.

This table is not all-inclusive. [3] DermNet lists 132 skin signs of systemic disease. [4,5] The table demonstrates the need for physicians to extend diagnosis beyond symptomatic cutaneous inflammation. It also reveals why some skin eruptions are resistant to topical treatments; the underlying condition must be addressed. Fingernail irregularities can also signal underlying disorders. [6]